Air embolism with neurologic complications: a potential hazard of central venous catheters.

In two patients air embolism caused by disconnection of subclavian venous catheters resulted in cerebral damage. Both patients were receiving long-term parenteral nutrition; both were in an upright position and were slightly dehydrated at the time the embolism occurred. The occurrence of air embolism during the insertion of central venous or subclavian catheters is well known, but the development of this complication in patients in whom the intravenous line becomes disconnected has not been stressed. It is important to recognize and treat the condition promptly. Also important in the prevention of this condition is catheterization in patients who are properly hydrated and who are in the Trendelenburg position, and care of the catheter thereafter.